new bbp training
TRANSCRIPT
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LEXINGTON FIREDEPARTMENT
Instructor: Johnny Sampson
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WHY ARE WE HERE? OSHA BB Pathogen standard
± anyone whose job requires exposure to BBpathogens is required to complete training
± employees who are trained in CPR andfirst aid
The more you know, the better you willperform in real situations!
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WHAT IS A BB PATHOGENPathogens are micro-
organismssuch as viruses, parasites,fungi or bacteria that cancause disease in people,
plants, and animals .
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WHAT IS AN EXPOSURE?1. Must involve exposure to blood, semen, vaginal
secretions, tissue or the following body fluids:cerebrospinal, amniotic, peritoneal, synovial,
pericardial, pleural2. Contact with EMR mucous membranes, non-intact
skin, or vascular system Examples, needlestickinjury, open wound, splash to eyes, nose, mouth
3. The exposure occurred in performance of employment or professional duties (includesemergency medical responders)
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Common BB PathogenDiseases
Malaria Brucellosis Syphilis
He patitis B( H BV)He patitis C( H CV)
H umanImmunod ef ici e ncyVirus ( H IV)
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Human ImmunodeficiencyVirus (HIV)
HIV is the virus that leads to AIDS
HIV depletes the immune system
HIV does not survive well outsidethe body
No threat on contracting HIVthrough casual contact
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Human Immunodeficiency Virus Human Immunodeficiency Virus
(HIV) (HIV)
jj HIV attacks the body's immune HIV attacks the body's immune system, weakening it so that itsystem, weakening it so that itcannot fight other deadly cannot fight other deadly
diseases.diseases.
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ACQU IRED IMM UN E ACQU IRED IMM UN E
DEFI C IE NCY S YN DROME DEFI C IE NCY S YN DROME
jj A IDS is a fatal disease, and A IDS is a fatal disease, and while treatment for it is while treatment for it is improving, there is no known improving, there is no known
cure.cure.
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HIV S Y MPTOMS HIV S Y MPTOMS
ÁÁ Weakness Weakness ÁÁ Fever Fever ÁÁ Sore throatSore throatÁÁ Nausea Nausea ÁÁ Headaches Headaches ÁÁ Diarrhea Diarrhea ÁÁ
White coating on the tongue White coating on the tongue ÁÁ Weight loss Weight loss ÁÁ Swollen lymph glands Swollen lymph glands
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Hepatitis B (HBV)
1²1.25 millionAmericans arechronically infected
Symptoms include:jaundice, fatigue,abdominal pain, lossof appetite,intermittent nausea ,vomiting
May lead to chronicliver disease, liver cancer, and death
Vaccination availablesince 1982
HBV can survive for atleast one week indried blood
Symptoms can occur 1-9 months after exposure
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WHAT IS HBV?± Is a virus that caus e s in fe ction andIs a virus that caus e s in fe ction and
in fl ammation o f th e live r in fl ammation o f th e live r
±± Is transmitt e d primari ly through "b loodIs transmitt e d primari ly through "b loodto b lood" contactto b lood" contact
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CONCENTRATION OF HBVHIGH
BLOODSERUM
WOUND DRAINAGE
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MODERATESEMEN
VAGINAL FLUIDSALIVA
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LOWURINEFECESSWEAT
TEARSBREAST MILK
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Hepatitis C (HCV) Hepatitis C is the most common chronicbloodborne infection in the United States
Symptoms include: jaundice, fatigue,abdominal pain, loss of appetite, intermittentnausea, vomiting
May lead to chronic liver disease and death
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W H A T AB O U T W H A T AB O U T
HEP A TITIS A? HEP A TITIS A? ÁÁ Hepatitis A Hepatitis A is a viral infection of is a viral infection of the liver caused by the Hepatitis A the liver caused by the Hepatitis A virus.virus.
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W H A T AB O U T W H A T AB O U T
HEP A TITIS A? HEP A TITIS A? Á Hepatitis A is a contagious disease thatspreads from person to person. A ffected
individuals must have eaten somethingthat had been directly or indirectly contaminated with the feces of another affected individual.
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W H A T AB O U T W H A T AB O U T
HEP A TITIS A? HEP A TITIS A? Á Hepatitis A is mostly transmitted by the fecal-oral route. It enters through the mouth,multiplies in the liver and is passed in the feces. The virus can then be carried on an infected person's hands and can be spread by direct contact, or by consuming food or drinkthat has been handled by the individual.
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W H A T AB O U T W H A T AB O U T
HEP A TITIS A? HEP A TITIS A? Á Hepatitis A can also be transmitted by contaminated water or ice, eating raw shellfishharvested from sewage contaminated water, or eating uncooked fruits, vegetables or other food that may have been contaminated duringprocessing.
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W H A T AB O U T W H A T AB O U T
HEP A TITIS A? HEP A TITIS A? Á Most adults who contract Hepatitis A develop symptoms that usually occur
suddenly and worsen over a period of several days. These often include loss of appetite, fatigue, nausea, vague stomach
pain, darkening of the urine, and jaundice .
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W H A T AB O U T W H A T AB O U T
HEP A TITIS A? HEP A TITIS A? Á The Hepatitis A virus can survive on surfaces ( such as toys and cutting boards)
for up to 1 month!
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W H A T AB O U T W H A T AB O U T
HEP A TITIS A? HEP A TITIS A? Á Hepatitis A has an incubation period of 15 to 50 days, with the average about 28
days. During this time, the individual may have no symptoms, but is contagious and spreading the virus!
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TRE A TME N T OF TRE A TME N T OF
HEP A TITIS A? HEP A TITIS A? B ecause Hepatitis A is a viral illness,antibiotics will not work. The virus
must run its course, and lasts for about4-6 weeks. Treatment is usually supportive, such as rest and hydration.A bout 15 % of individuals require hospitalization.
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TRE A TME N T OF TRE A TME N T OF
HEP A TITIS A? HEP A TITIS A? A typical case of Hepatitis A results in 27 lost days of work. A small percentage
will require liver transplant. The adultdeath rate is 27 per 1000 cases. ( Ab out100 per year in U .S.) Most are older withprevious health pro b lems.
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PREVE N TIO N OF PREVE N TIO N OF
HEP A TITIS A? HEP A TITIS A? Á Prevention is bestaccomplished by proper hand
washing! Á Proper cleaning and preparation of foods.Á Proper cleaning of food prep areas.
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THE GOOD N E W S AB O U T THE GOOD N E W S AB O U T
HEP A TITIS A? HEP A TITIS A? Á Once recovered from Hepatitis A , you are immune
for life!
Á There is a vaccine
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OTHER BL OOD B OR N E P A THOGE N S OTHER BL OOD B OR N E P A THOGE N S
Malaria Malaria ÁÁ U sually U sually transmitted by the transmitted by the bite of an infective mosquito bite of an infective mosquito ÁÁ May May be transmitted by be transmitted by injection or transfusion withinjection or transfusion withblood of infected persons or blood of infected persons or contaminated needles and contaminated needles and syringes by drug users.syringes by drug users.
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OTHER BL OOD B OR N E P A THOGE N S OTHER BL OOD B OR N E P A THOGE N S
Syphilis Syphilis ÁÁ U sually transmitted by directU sually transmitted by directcontact with infectious contact with infectious
exudates from obvious or exudates from obvious or concealed, moist, early, lesions concealed, moist, early, lesions of skin and mucous of skin and mucous
membranes.membranes.
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OTHER BL OOD B OR N E P A THOGE N S OTHER BL OOD B OR N E P A THOGE N S
Syphilis Syphilis ÁÁ A lso transmitted by contactA lso transmitted by contactwith body fluids and with body fluids and
secretions (saliva, semen,secretions (saliva, semen,blood, vaginal discharges) of blood, vaginal discharges) of infected people.infected people.
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Potentially Infectious Bodily
Fluids
Blood Saliva Vomit Urine Semen or vaginalsecretions
Skin tissue, cellcultures
Any other bodilyfluid
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AIRBORNE BAD STUFF
TUBERCULOSIS
MENINGITIS
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TUBERCULOSIS
Is an infectious disease which usually
infects the lungs, but may affect other body systems as well. Caused by Mycobacteriumtuberculosis. Spread airborne by droplets
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TUBERCULOSIS
SYMPTOMS COUGH LASTING LONGER
THAN 2 WEEKS COUGHING UP BLOOD CHEST PAIN SOB
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TUBERCULOSIS
SYMPTOMS WEIGHT LOSS
CHILLS NIGHT SWEATS FEVER LOSS OF APPETITE
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TUBERCULOSIS
TREATMENT Antibiotics are used to kill the
bacteria. ionized (INH) rifampin
pyrazinamide Possible side effects are liver disease.
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M ENINGITIS Two types: Viral (or Aseptic) and
Bacterial
Infection of the meninges (a thinlining covering the brain and spinalcord) Transmitted by the exchange of respiratory or throat secretions.(coughing, sneezing, sharing a cup,etc.) from an infected person
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M ENINGITIS
Fever
Stiff neck Headache Nausea / vomiting Drowsiness Mental status changes
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V IRAL
M ENINGITIS
Caused by many different
viruses (enteroviruses andmumps virus are two types) Patients recover on their own Bed rest, pain control Lasts 7-14 days
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M ENINGITIS
Diagnosed by spinal tap, CSF ischecked in lab. The diagnosis is then made bygrowing bacteria from a sample of
spinal fluid
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BACTERIALM ENINGITIS
Caused by exposure to one of threetypes of bacteria:Neisseria meningitidisStreptococcus pneumoniae
Haemophilus influenzae
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BACTERIALM ENINGITIS
Advanced bacterial meningitis canlead to brain damage, coma, anddeath. Survivors can suffer long-term complications, includinghearing loss, mental retardation,paralysis, and seizures.
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BACTERIALM ENINGITIS
Anyone can get bacterial meningitis, but it ismost common in infants and children.People who have had close or prolongedcontact with a patient with meningitis canalso be at increased risk. This includes
anyone with direct contact with dischargesfrom a meningitis patient's mouth or nose.
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BACTERIALM ENINGITIS
TRANSMITTED BY DROPLETS
IN THE AIR.
WE MAY NOT KNOW THEPATIENT HAS THIS UNTIL WEGET EXPOSED!
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BACTERIALM ENINGITIS
IF WE GET EXPOSED, WE
MAY BE TREATED WITHCIPRO OR ANOTHER TYPEOF ANTIBIOTIC THAT THE
MD RECOMMENDS.
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BACTERIALM ENINGITIS
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BACTERIALM ENINGITIS
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There is now a vaccine for meningitis
Vaccine is based on bacteria mostresponsible for menigitis
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M RSA AND
V RE
MRSA STANDS FOR METHICILLINRESISTANT STAPHYLOCOCCUS AUREUSINFECTION.
METHICILLIN IS A TYPE OF ANTIBIOTIC. STAPHYLOCOCCUS AUREUS IS A TYPEOF BACTERIA COMMONLY FOUND ONTHE SKIN AND NOSES OF PEOPLE.
IT IS USUALLY HARMLESS AT THESE
SITES.
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M RSA AND
V RE
IF THE BACTERIA GETS INTO THEBODY THROUGH BREAKS IN THESKIN, INFECTIONS CAN SET IN.
IN HEALTHY INDIVIDUALS, THIS ISUSUALLY NOT A PROBLEM.
IN SICK PATIENTS, THE INFECTIONMAY BECOME SERIOUS.
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M RSA AND
V RE
MRSA IS SPREAD THROUGHDIRECT CONTACT WITH A PATIENT,AND THEN TOUCHING OTHERPATIENTS WITHOUT USING PROPERCLEANING AND HAND WASHING
PROCEDURES.
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WHAT SHOULD WE DO?
ALWAYS WEAR GLOVES. KEEP THE PATIENT COVERED WITHA SHEET.
AVOID TOUCHING THE PATIENTDIRECTLY, IF POSSIBLE.
WASH HANDS THOROUGHLY AFTERPATIENT CONTACT.
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WHAT SHOULD WE DO?
THE WATERLESS HAND CLEANERSHOULD BE USED AFTERREMOVING YOUR GLOVES.
EQUIPMENT USED FOR THEPATIENT SHOULD BE DISINFECTED
PROPERLY BEFORE BEING USEDON ANOTHER PATIENT.
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ISOLATION SIGNS
Look for them Where??
What are other signs you need toprecautions???
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V RE
VANCOMYCIN RESISTANTENTEROCOCCI
THESE ARE BACTERIA THATHAVE DEVELOPED ARESISTANCE TO MOST
ANTIBIOTICS. VRE CAN CAUSE INFECTIONS,ESPECIALLY IN SICK PEOPLE.
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V RE
THESE INFECTIONS AREDIFFICULT TO TREAT, DUETO THEIR RESISTANCE TOTHE ANTIBIOTICVANCOMYCIN , WHICH ISONE OF THE STRONGESTANTIBIOTICS AVAILABLE.
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V RE
PROPER USE OF PPE ANDHAND WASHING IS THEBEST WAY TO PREVENT THESPREAD OF VRE.
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NOROV
IRUS A GROUP OF VIRUSES THAT CAUSEACUTE GASTROENTERITIS (ANINFLAMMATION OF THE STOMACH ANDINTESTINES)( AKA ³ STOMACH FLU´) INHUMANS.
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NOROV
IRUS SYMPTOMS START SUDDENLY, ANDINCLUDE:
STOMACH CRAMPS NAUSEA VOMITING
DIARRHEA HEADACHES LETHARGY
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NOROV
IRUS THE CDC ESTIMATES THAT 23 MILLIONPEOPLE A YEAR CONTRACTNOROVIRUS.
232 OUTBREAKS IN U.S. IN A 3 YEARPERIOD.
57% FOODBORNE 16% PERSON TO PERSON 3% WATERBORNE
23% UNDETERMINED
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NORO V IRUS COMMONSETTINGS FOROUTBREAKS:
RESTAURANTS /CATERED MEALS(36%)
NURSING HOMES(23%)
SCHOOLS (13%) CRUISE
SHIPS(10%)
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NOROV
IRUS MOST FOODBORNE OUTBREAKS ARELIKELY TO ARISE THROUGH DIRECTCONTAMINATION OF FOOD BY A FOODHANDLER.
FOOD CAN ALSO BE CONTAMINATEDAT THE SOURCE, SUCH AS OYSTERSFROM CONTAMINATED WATERS.
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NOROV
IRUS The best
prevention isfrequent handwashing!
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Transmission Potential Contact with another person¶s blood or bodily fluid that maycontain blood
Mucous membranes:eyes, mouth, nose
Non-intact skin Contaminatedsharps/needles
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Your Exposure Potential
Industrial accident Administering first aid
Post-accident cleanup Handling of returned
product Janitorial or
maintenance work Handling of any waste
products
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Universal Precautions
Use of proper PPE Treat all blood and
bodily fluids as if they are contaminated
Proper cleanup anddecontamination
Disposal of allcontaminated materialin the proper manner
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Personal Protective
Equipment (PPE) Anything that isused to protect a
person fromexposure
Latex or Nitrilegloves, goggles,CPR mouth barriers,aprons, respirators
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PPE Rules to Remember
Always check PPE for defects or tearsbefore using
If PPE becomes torn or defectiveremove and get new
Remove PPE before leaving a
contaminated area Do not reuse disposable equipment
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Decontamination When cleaning up surfaces use approveddisinfectant ®
Do an initial wipe up
Spray and allow it to stand for ten minutesthen wipe up Dispose of all wipes in biohazard containers PPE should be removed anddisposed of in biohazard containers
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Hand Washing
Wash handsimmediately after
removing PPE Use a softantibacterial soap
A hand sanitizer canbe used but washwith soap and water as soon as possible.
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Regulated Medical Waste
Liquid or semi-liquid blood or other potentiallyinfectious material(OPIM)
Contaminated items that would release bloodor OPIM when compressed Contaminated sharps Pathological and
microbiological wastecontaining blood or OPIM
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Signs & Labels
Labels must include theuniversal biohazardsymbol, and the term³Biohazard´ must beattached to:± containers of regulated
biohazard waste± refrigerators or freezers
containing blood or OPIM
± containers used to store,transport, or ship bloodor OPIM
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Exposure Incident
A specific incident of contact with potentiallyinfectious bodily fluid
If there are no infiltrations of mucousmembranesor open skin surfaces, it is not considered anoccupational exposure
Report all accidents involving blood or bodilyfluids Post-exposure medical evaluations are offered
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Post-exposure Evaluation
Confidential medicalevaluation
Document route of
exposure Identify source
individual Test source individuals
blood (with individuals
consent) Provide results to
exposed employee
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Hepatitis B Vaccination
Strongly endorsedby medicalcommunities
Offered to allpotentially exposedemployees
Provided at no costto employees
Declination form
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Recordkeeping
Medical records include: Hepatitis B vaccination
status
Post-exposureevaluation and follow-up results
Training records include: Training dates
Contents of the training Signature of trainer andtrainee
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In Conclusion
BB pathogen rules are in place for your health and safety
Failure to follow them is a risk thatdoes not need to be taken